Complaint Investigation Report

494700034-4-26-2024-47-HC-WSCT-D7GPQR-20240724113135

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE SERVICES , 744 P STREET, MS 09-14-90

This is an official report of an unannounced visit/investigation of a complaint received in our office on

02/23/2024 and conducted by Evaluator Todd Borcher

COMPLAINT CONTROL NUMBER: 47-HC-20240223095736

HCO is not providing services to client as contracted.

Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business address provided for Divine Fijian's Home Care, located at 3270 Mendocino Avenue, Santa Rosa, CA 95403. Analyst Borcher met with Licensee Poasa Koroitamana to discuss the above complaint allegation.

Based on the evidence obtained and interview conducted, the allegation is outside the scope of the Home Care Services Bureau’s jurisdiction, therefore is UNSUBSTANTIATED.

Analyst Borcher concluded the visit with an exit interview and provided a copy of the HCS 9099 investigation report along with appeal rights.